Letters Section Editor: Jody W. Zylke, MD, Senior Editor.
Author Affiliations: Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland (firstname.lastname@example.org).
To the Editor: In the Rational Clinical Examination article by Dr Coburn and colleagues1 on whether a patient with suspected bacteremia requires blood cultures, a clinical prediction rule developed by Shapiro et al2 was highlighted as one of the few useful means of detecting patients with a low likelihood of bloodstream infection. The article reported that this rule has a negative likelihood ratio of 0.08 (95% CI, 0.04-0.17) for the presence of bacteremia. Therefore, the rule may allow clinicians to safely avoid blood cultures when applied accurately to patients with suspected infection and a low pretest probability of bacteremia.
Eckert P, Bayram JD, Omron R. Blood Culture Collection for Suspected Bacteremia. JAMA. 2013;309(4):339. doi:10.1001/jama.2012.113517